During pushing and delivery, your baby’s head will begin to show through your vaginal opening with each contraction. When your baby’s head remains visible without slipping back in, it is known as crowning.

What you should know about crowning:

When your baby’s head crowns, you will experience a burning or stinging sensation, often referred to as “the ring of fire,” as your baby stretches the vaginal opening. As soon as you feel this sensation, stop pushing! It is very important to stop pushing at this point because continuing to push and bear down increases the risk of tearing or the need for an episiotomy. If you forget, your doctor or midwife will remind you.

The burning or stinging sensation only lasts for a short time and is followed by a feeling of numbness. The numbness comes from the baby’s head stretching the vaginal tissue so thin that the vaginal nerves are blocked. The effect is like a natural anesthetic. There is no set time frame for how long this step of delivery will last.

Tips to fight that urge to push:

Lean back and try to go limp.

Make a conscious effort to relax the muscles of the perineal floor (the layers of muscles and tissue between the vagina and rectum).

]]>http://americanpregnancy.org/labor-and-birth/crowning/feed/0Back Laborhttp://americanpregnancy.org/labor-and-birth/back-labor/
http://americanpregnancy.org/labor-and-birth/back-labor/#commentsThu, 26 Apr 2012 17:31:06 +0000http://americanpregnancy.org/?p=908Labor and giving birth are among the most physically demanding things that a woman will ever experience. Many woman try to prepare for the experience by working...

Labor and giving birth are among the most physically demanding things that a woman will ever experience. Many woman try to prepare for the experience by working on their health, exercising and becoming more educated about labor. One thing many woman hope they can avoid is the dreaded “back labor.” Many women are unaware of solutions and remedies for this common condition in the labor experience.

What is Back Labor?

“Back labor” refers to the pain and discomfort that laboring women experience in their lower back. Although most women will feel a degree of achiness or slight cramping in the back at some point during labor, about a quarter of all women report experiencing severe discomfort in the lower back that is most intense during contractions and often painful between contractions. Back labor can often be accompanied by an irregular contraction pattern, labor that is slow to progress, and a prolonged pushing stage.

What causes Back Labor?

A frequent cause of back labor is the position of the baby. Positions such as occiput posterior (when baby is facing the mother’s abdomen) can cause pressure from the baby’s head to be applied to the mother’s sacrum (the tailbone). The result can be intense discomfort during labor. However, a baby in an odd position does not always result in back labor. Similarly, back labor is not always the result of a baby’s positioning. Some research has shown that a woman who experiences back pain during her menstrual cycle may be more likely to experience back labor regardless of the baby’s position.

How can Back Labor be treated or relieved?

The best way to relieve back labor is to get the laboring mother off of her back. If the back labor is thought to be caused by fetal position, there are techniques that can be used to change the position of the baby. If the cause of back labor is unknown, using the proven techniques for repositioning the baby is a good place to start. Other comfort measures can also be helpful.

Techniques to help improve fetal position:

Walking

Squatting and lunging

Sitting on a birth ball

Using a rebozzo or sheet to shift the pelvis

Pelvic tilts and hula-hoop dancing

Hands and knees and/or open knee chest positions

Sitting backwards on a chair or the toilet

Techniques to ease discomfort:

Hot or cold compresses applied to the lower back

Strong counter-pressure

Hydrotherapy using a shower, warm bath, or birth pool

Heated rice sock

Applying pressure with something that rolls down the back such a water bottle, beverage can, tennis ball or hollow rolling pin.

Using a combination of techniques for positioning and the comfort measures increases the chances that the woman experiencing labor will get some relief from her back pain. Taking a comprehensive childbirth class in advance of labor and/or having professional labor support by a doula can also be very beneficial.

Can Back Labor cause complications for me or my baby?

Back labor by itself cannot harm the baby or the mother.

However, research shows that a baby in an undesirable position in the womb–the most common cause of back labor–is more likely to experience difficulty descending through the birth canal leading to interventions and complications that include:

Can Back Labor be prevented?

A woman will not be able to know prior to labor if she will experience back labor. However, some studies show that a woman who has experienced back labor in the past is more likely to experience it in the future unless preventative measures are taken. Because back labor is most often caused by the position of the baby, steps can be taken to help increase the chances of a favorable fetal position.

Such steps include:

During pregnancy:

Do pelvic tilts—Get on hands and knees, curl your back up and then resume a straight position. This exercise not only helps loosen ligaments but can also provides relief for an aching back after a long day.

Spend time each day sitting on a birth ball/exercise ball.

Sit in positions that keep your knees lower than your hips—However, avoid spending too much time sitting deep in your couch or other recliner chairs!

Regularly ask about the position of your baby as your pregnancy progresses.

During Labor:

Get off your back!! Being in the supine position (lying on your back) during labor increases the possibility of back labor and can make it much more painful. If you need to lie down, choose a position on your side or some sort of tilt position.

Use gravity friendly positions early in labor—This includes walking, swaying, sitting on a ball, semi-sitting or leaning.

Pelvic tilts ( as previously described)

If you feel the need to sit, try sitting backwards on a chair or on a toilet.

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http://americanpregnancy.org/labor-and-birth/inducing-labor/#commentsThu, 26 Apr 2012 17:25:07 +0000http://americanpregnancy.org/?p=905Inducing labor is the artificial start of the birth process through medical interventions or other methods. Induction not done for medical reasons or as an...

Inducing labor is the artificial start of the birth process through medical interventions or other methods. Induction not done for medical reasons or as an emergency is considered elective. Induction of labor has recently been on the rise for purposes of convenience or to accommodate busy schedules. However, according to the American College of Obstetricians and Gynecologists (ACOG), labor should be induced only when it is more risky for the baby to remain inside the mother’s uterus than to be born.

What are some medical reasons for inducing labor?

If the baby is in danger of not getting enough nutrients and oxygen from the placenta.

The amniotic sac has ruptured but labor hasn’t started within 24-48 hours.

The pregnancy is prolonged beyond 42 weeks with possible risk to the baby from a gradual decrease in the supply of nutrients from the placenta.

There is an infection inside the uterus known as chorioamnionitis.

How is labor induced?

Labor can be induced by the following methods:

1. Medications:

Prostaglandin: Suppositories are inserted into the vagina during the evening causing the uterus to go into labor by morning. One advantage to this method is that the mother is free to move around the labor room.

Oxytocin: The body naturally produces the hormone oxytocin to stimulate contractions. Pitocin and Syntocinon are brand name medications that are forms of oxytocin that can be given through an IV at low doses to stimulate contractions.

What are the advantages of taking oxytocin?
Oxytocin can initiate labor which might not have started on its own and it can speed up the pace of labor.

What are the concerns when taking oxytocin?
Labor can progress too quickly, causing contractions to become difficult to manage without pain medication. Oxytocin may need to be discontinued if contractions become too powerful and close together.

2. Artificial rupture of the membranes (AROM): When the bag of water (amniotic sac) breaks or ruptures, production of the hormone prostaglandin increases, speeding up contractions. Some health care providers might suggest rupturing the amniotic membrane artificially. A sterile, plastic, thin hook is brushed against the membranes just inside the cervix causing
the baby’s head to move down against the cervix, which usually causes the contractions to become stronger. This procedure releases a gush of warm amniotic fluid from the vagina.

What are the Advantages of artificial rupture of the membranes?

Labor may be shortened by an hour.

The procedure allows the amniotic fluid to be examined for the presence of meconium, which may be a sign of fetal distress.

The heart rate can be monitored with direct access to the baby’s scalp.

What are the Disadvantages of artificial rupture of the membranes?

The baby may turn to a breech position, making birth more difficult if the membranes are ruptured before the baby’s head is engaged.

It is possible for the umbilical cord to slip out first (prolapsed cord).

Infection can occur if there is too much time between rupture and birth

3. Natural: Nipple Stimulation is a natural form of labor induction that can be done manually or with an electric breastfeeding pump. The hormone oxytocin will naturally be produced to cause contractions. The concept is the same as when a baby nurses right after birth, stimulating contractions, which slows bleeding.

What expectations should I have about induced labor?

You can still do breathing exercises and push at your own pace if you prefer to avoid pain medications throughout the
delivery.

You can also request an epidural anesthetic or some other form of pain relief if needed.

The following questions can be helpful when you do not understand or feel comfortable with suggested interventions:

Why do I need this procedure?

How will it help me and my baby?

Are other options available? If so, what are they? What are the risks?

]]>http://americanpregnancy.org/labor-and-birth/inducing-labor/feed/0Effacementhttp://americanpregnancy.org/labor-and-birth/effacement/
http://americanpregnancy.org/labor-and-birth/effacement/#commentsThu, 26 Apr 2012 17:17:15 +0000http://americanpregnancy.org/?p=902 The closer you get to the end of your pregnancy, the more you will hear about “being effaced,” “effacing,” or “effacement.” What is effacement? Effacement...

The closer you get to the end of your pregnancy, the more you will hear about “being effaced,” “effacing,” or “effacement.”

What is effacement?

Effacement is the process by which the cervix prepares for delivery. After the baby has engaged in the pelvis, it gradually drops closer to the cervix; the cervix gradually softens, shortens and becomes thinner. You might hear phrases like “ripens,” or “cervical thinning” which refer to effacement.

How is effacement measured?

Effacement is measured in percentages. For example, your health care provider may tell you that you are effaced 50%, which means you are half way to being completely effaced. When you are 100% effaced or completely effaced, your cervix is paper-thin and labor is right around the corner.

How will I know if and when I am effaced?

In your final weeks of pregnancy your health care provider will routinely check for effacement and as soon as you arrive at your birth location, you will be checked for effacement. If you are a first time mother, your cervix will usually efface before it dilates. If you have previously had children, your cervix will usually dilate before effacement.